Cannabis Use Patterns Differ by Sexual Identity, Attraction, and Gender | Research

The takeaway

Bisexual women had the highest cannabis use rates, with 2.57 times the odds of both vaping and non-vaping cannabis compared to heterosexual women, while men showed different disparity patterns.

LGBTQ+ health researchers, public health professionals, substance use prevention specialists, and sexual minority individuals.

Bisexual women: 2.57x odds of cannabis use

What the researchers found

Among women, bisexual identity was linked to the highest odds of cannabis vaping (aOR=2.57) and non-vaping use (aOR=2.57). Women with same-sex or both-sex attraction had higher odds of both use modes. Heterosexual-discordant women (heterosexual identity but non-heterosexual attraction) were also at increased risk. Among men, disparities were more consistently linked to non-vaping cannabis use.

Why it matters

This is the first study to examine cannabis use across multiple dimensions of sexual orientation (identity, attraction, concordance/discordance) and by delivery method. Understanding these nuanced patterns is essential for reducing substance use disparities in sexual minority populations.

The numbers in context

N=40,030. Bisexual women: aOR=2.57 for both vaping and non-vaping cannabis. Same-sex attracted women had elevated odds of both modes. Men showed disparities primarily in non-vaping use. Analysis adjusted for demographic variables and other substance use.

How the study worked

Analysis of 2022 NSDUH nationally representative data (N=40,030) using weighted multivariable logistic regression examining associations between sexual orientation dimensions and past-30-day cannabis vaping and non-vaping use.

What this study cannot tell us

Cross-sectional data cannot establish causation. Self-reported sexual orientation and cannabis use. The 2022 NSDUH may not capture all dimensions of sexual orientation. Cannabis vaping and non-vaping categories may overlap in some individuals.

How to read the evidence

Nationally representative dataset (NSDUH) with strong methodology and large sample, though cross-sectional design limits causal inference.

When this study was published

2026 study analyzing 2022 data.

The bigger picture

Sexual minority stress theory suggests higher substance use in SM populations results from discrimination, stigma, and identity-related stressors. The gender-specific and modality-dependent patterns found here suggest that prevention efforts need to be tailored rather than one-size-fits-all.

Questions still open

Why do bisexual women show the highest cannabis use rates? Do the different use modality patterns between men and women reflect different social contexts or motivations for use?

Common questions

Do LGBTQ+ people use more cannabis?

This nationally representative study found sexual minority individuals, particularly bisexual women, had significantly higher cannabis use rates. The patterns varied by gender, specific sexual orientation dimension, and method of use.

Why would sexual orientation affect cannabis use?

Sexual minority stress theory suggests that discrimination, stigma, and identity-related challenges may drive higher substance use rates. The specific patterns differ by gender and sexual orientation dimension.

Read the original research

Cannabis use among sexual minority adults: insights from recent U.S. nationally representative data.

Addictive behaviors, 172, 108495

View on PubMed ↗Publisher’s paper ↗

Citation

Qin, Weisiyu Abraham; Elam, Kit K; Lederer, Alyssa M; Seo, Dong-Chul. (2026). Cannabis use among sexual minority adults: insights from recent U.S. nationally representative data.. Addictive behaviors, 172, 108495. https://doi.org/10.1016/j.addbeh.2025.108495